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Kentucky Medicaid Companion Guides

Companion Guide instructions are displayed in Adobe
Acrobat formats.

The transaction under HIPAA is the standard electronic exchange of
information between two parties to carry out financial activities related to
health care. The health care claim or equivalent encounter information
transaction is the transmission of either of the following:

A request to obtain payment, and the necessary accompanying information from a
health care provider to a health plan, for health care.

If there is no direct claim, because the reimbursement contract is based on a
mechanism other than charges or reimbursement rates for specific services, the
transaction is the transmission of encounter information for the purpose of
reporting health care.

Companion guides document situational fields from the Implementation Guide,
that are required to process Kentucky Medicaid claims. However, the documents
are not the complete EDI transaction format.